Patient Preference and Adherence (Jan 2022)
Exploring Stem Cell Transplanted Patients’ Perspectives on Medication Self-Management and Electronic Monitoring Devices Measuring Medication Adherence: A Qualitative Sub-Study of the Swiss SMILe Implementation Science Project
Abstract
Janette Ribaut,1,2 Sabina De Geest,1,3 Lynn Leppla,1,4 Sabine Gerull,2,5 Alexandra Teynor,6 Sabine Valenta1,2 On behalf of the SMILe study team1Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland; 2Department of Theragnostic, Hematology, University Hospital of Basel, Basel, Switzerland; 3Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; 4Departments of Hematology, Oncology and Stem Cell Transplantation, Medical Center University of Freiburg, Freiburg, Germany; 5Department of Hematology, Cantonal Hospital of Aarau, Aarau, Switzerland; 6Department of Computer Science, University of Applied Sciences, Augsburg, GermanyCorrespondence: Sabine ValentaInstitute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Bernoullistrasse 28, Basel, CH-4056, SwitzerlandTel +41 61 32 85275Email [email protected]: Little is known about allogeneic stem cell transplant (alloSCT) patients’ medication adherence strategies. Acceptability and preferences regarding electronic monitoring (EM) systems to assess all three phases of medication adherence (ie, initiation, implementation, persistence) are crucial to allow their successful implementation in clinical or research settings but have not yet been evaluated. We therefore aimed to explore: 1) alloSCT patients’ medication adherence and self-management strategies; and 2) their acceptability and preferences of three different EM systems (MEMS Cap, Helping Hand, Button) as part of the Swiss SMILe study.Patients and Methods: Respecting anti-pandemic measures, we used a purposive sample of six adult alloSCT patients from the University Hospital Basel, Switzerland (USB)— 6 weeks to 2 years post-alloSCT—to conduct three focus group sessions with two patients each. Using a semi-structured outline, we explored 1) patients’ medication adherence strategies and medication self-management; and 2) their acceptance and preferences regarding EM use. The three tested EM systems were available for testing during each session. Discussions were audio-recorded, visualized using mind-mapping and analyzed using Mayring’s qualitative content analysis.Results: Patients (33% females; mean age 54.6± 16.3 years; 10.4± 8.4 months post-alloSCT) used medication adherence enhancing strategies (eg, preparing pillbox, linking intake to a habit). Still, they indicated that post-alloSCT medication management was challenging (eg, frequent schedule changes). All participants preferred the MEMS Button. Participants said its small size and the possibility to combine it with existing pillboxes (eg, putting it into/next to them) made them more confident about implementing it in their daily lives.Conclusion: Regarding EM systems for medication adherence, end-user preferences and acceptability influence adoption and fidelity. Of the three systems tested, our sample found the MEMS Button most acceptable and most preferable. Therefore, we will use it for our USB SMILe study.Keywords: allogeneic hematopoietic stem cell transplantation, medication adherence, electronic monitoring, patient empowerment, focus groups
